Showing posts with label aural rehab. Show all posts

Resource List: Keeping Hearing Aids on Young Children...

It's surely no surprise that keeping hearing aids (HA) and/or cochlear implant (CI) on little ones is a near impossible feat...
According to research reported by Anderson & Madell (2014), only about 10% of children achieve full time hearing aid wear (defined as 12 hours/day) & 40% of children wear their hearing aids 4 hours or less per day!! These numbers make me want to rip my hair out... if the kids aren't wearing their equipment, then they aren't hearing ... and if they aren't hearing then how will they ever to listen & speak? Figuring out how to keep the hearing equipment on little ones is an ongoing struggle and continues to be the #1 discussion that I have with caregivers.

The Anderson & Madell article linked above has some really awesome printable brochures for families that are full of fantastic ideas for how to keep hearing aids on children birth-kindergarten. Their list of retention ideas is also great -- they include parent ratings of different products & lots of detailed information about the development of listening skills from infancy through kindergarten age.

Below, I've compiled my own list of resources for products to help keep hearing aids on young children including commercially produced, handmade & DIY solutions ... in terms of ages, the effectiveness & appropriateness of the solutions listed will vary greatly from child to child - again see Anderson & Madell (2014) for a parent review of effectiveness & suggestions by age group. Now onto my list...
Most simply, there are four primary categories of 'hearing equipment retainers' for children:
  1. Caps/Hats
  2. Cords/Clips 
  3. Headbands 
  4. Adhesive/Tape
Caps & Hats
For very young children, one of the first suggestions frequently is a tight fitting 'pilot' cap style hat that covers the ears & hearing equipment and ties securely. This makes it more difficult for babies to pull their hearing aids out... but not impossible! Look for a tight fitting cap made of light weight material & strings long enough to tie securely.

Commercially Available Pilot Caps: 

Handmade Pilot Caps: 

 DIY Options:

Cords & Clips
This options is pretty simple -- a cord (i.e. string) of some sort attaches to the child's hearing equipment and then is secured to the child's clothing. If the equipment comes off, it doesn't go far!

Commercially Available Options: 

Handmade Options:

DIY Options:
Dental Floss & Safety Pin
Sunglasses Holder & Safety Pin

Headbands
Headbands for behind-the-ear (BTE) hearing aid & CI's are specially designed with loops and/or pockets to hold the behind-the-ear portion - that is often too heavy for the tiny ears of an infant or toddler. Look for light weight materials and avoid covering the microphone area of the HA/CI.

Handmade Options 

DIY Options 

Toupee/Wig & Medical  Tape 
Toupee/wig and medical tape are adhesives that are specially designed for use on the skin - but can potentially be irritating to sensitive skin. Toupee/wig tape (i.e. double sided tape) can be trimmed to size then placed on a BTE hearing aid or CI processor - on the side that rests against the head. Medical tape (i.e. single sided tape) can be placed over the earmold portion of the hearing aid - over the entire outer ear. Used alone, adhesive options are not especially reliable, but are a nice addition to other methods. (affiliate links below for your convenience)

Toupee/Wig Tape

Medical Tape

References: 
Anderson K, J Madell. Improving hearing and hearing aid retention for infants and young children. Hearing Review. 2014;21(2): 16-20.


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In the News: Hearing Aids Improve Outcomes...

Well.... yeah! A recent study indicates that when children with hearing loss wear hearing aids, their speech & language abilities improve - seems kind of like a no-brainer, but it's a little piece of tangible evidence to support what many speech, language and hearing professionals have known for years. The more that kids wear their hearing aids, the better they do!


The study looked at a relatively small group of 180 three to five year old children with mild-moderate and moderate-severe hearing loss - the study did not include children in in the severe-profound range.  The researchers collected information on speech, language & articulation performance, hearing loss degree and hearing aid wear time. Two important facts were noted in their results:
  1. Children who received the most benefit from their hearing aids showed higher speech & language scores. 
  2. And, duration of hearing aid wear improved outcomes -- especially in children who received the most benefit from their hearing aids. 
These results provide a strong rationale for children with a mild hearing loss to receive & wear hearing aids - as they stand to benefit the most! For children with a moderate-severe hearing loss, it provides support to double & triple check hearing aid programing in order to ensure maximum gain - the more access to sound that these children receive from their hearing aids, the greater the potential long term outcomes!

Whether you're a parent or a teacher, the next time you hear (or think): 'He does fine without his hearing aids - why fight this battle?' remember this study! As a teacher who deals with this issue frequently, I often counter with my own question: How much better could he do if he could hear like you do?  

Check out the Reuters article for more information or the original article from the JAMA Otolaryngology - Head & Neck Surgery.


References: 
Doyle, K. (13 Apr. 2014). Hearing aids for kids could improve speech and language. Reuters Online. Retrieved from: http://www.reuters.com/article/2014/04/07/us-hearing-aids-idUSBREA361HJ20140407

Tomblin J, Oleson JJ, Ambrose SE, Walker E, Moeller M. (2014). The influence of hearing aids on the speech and language development of children with hearing loss. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2014.267.
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Listen! I hear audiobooks...

Over the last couple of months, I've purchased quite a few audiobooks through our school's Scholastic book orders and have been trying to figure out how to best set up a listening center for my preschool students who have varying degrees of hearing loss AND different amplification devices. Some of the audiobooks have been pretty good, with music and/or sound effects that compliment the story while others, have been awful renditions! Here's what I came up with so far:


I dug out my old iPhone, cleared off the content & set it up with some of the audiobook mp3 files. Since it was an old iPhone 3, I was unable to upgrade to the newest operating system, so I moved all of the icons except for the 'music' icon off to the 2nd and 3rd screen (on newer devices, you can 'drag them on top' of each other to put them into other 'folders.') I also went into settings & restricted internet, email & camera access to make the phone less functional - so my kids could only use it for the purpose intended. This is much easier on newer devices and can easily be set under the accessibility menu to only grant access to a single function at a time. I used the internet to add cover art to each of the audio tracks so that my non-reading Prek students could easily figure out which audio file matched the book they wanted to read.


With the help of our audiologist, I collected audio accessory cables & other connectors for the array of hearing aids that my students have including Phonak, Oticon & Cochlear Ltd. products. I also had to get a headphone jack adapter because of the recessed headphone jack in the old iPhone made it impossible to plug in the audio cords - my techie husband helped me out with this! Here's a picture of all of the listening center supplies in their box (I found these great Lego storage boxes on clearance at my local Walmart - they're just the right size for a bunch of books!)


We've experimented with the audio cables for direct input - which has been interesting. Some of the kids like the direct input, while others seem to prefer to hold them up to their 'ear' like a telephone. Some students have even quite accurately named this activity the 'book phone.'

I was a bit surprised by how much my students engaged with this activity! Most of my students are doing very well with it & find it fun - however, I think that it's worth noting that all of the students who have found it enjoyable also have pretty good auditory comprehension & receptive language skills - but not necessarily 'mild' hearing loss; some of the students that like this the most actually have a severe-profound loss & have to work VERY hard to understand what they're hearing! For students who have lower receptive language skills, I think that I will be working on recording alternates with simplified language, no sound effects & integration of learning to listen sounds/simple songs.

I also MUST mention that listening activities like this are absolutely NOT a substitute for having high quality conversations & interactions with young children who have hearing loss. The use of these audiobooks isn't necessarily intended to improve their language skills, but rather provide an interesting opportunity to engage with technology in a way similar to my students' hearing peers. I'd venture to guess that most preschoolers have probably played a game on a caregiver's phone or tablet from time to time - but my students, while they've all likely engaged with technology, have probably missed out on a significant portion of the music and sound effects that go with it. Listening centers are a way for my students who have hearing loss to engage in experience with technology more like their hearing peers do - and if we end up working on language skills - great!

Since setting up the first listening center, I've located two additional older iPhones from family & friends and I'm working on also setting them up for use in my classroom!  This is definitely something that we'll continue to explore in the classroom... check back for more of our experiences with these listening centers.

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Thanks for Thanksgiving...

Here are a few of the Thanksgiving activities and crafts we've been working on... I just haven't had time to get them all posted! The following activities are heavy on receptive and expressive language practice!

Last week, we learned about letter T. Here's our Letter T turkeys...


I had my classroom assistant pre-cut all the pieces for this craft. The children practiced following directions with specific shape, color and location vocabulary concepts. Before we got started, I introduced all the pieces and named them by shape, color and which part of the turkey each piece would be. I verbally reviewed the steps involved and layed the pieces together on my page for my students to see. Then, my students helped to tell me the directions. When they got stuck, I gave the direction and had them listen carefully to choose the pieces - the brown half circle vs. the brown circle etc.

We read the book "Today is Monday" by Eric Carle and sang the book. I found this great little write-on version with a dry erase marker at a local discount store. I asked each child to name a food as we read and I drew a picture of the food and wrote the words while we read.


We also played the "Today is Monday" game - another item I picked up somewhere for cheap! Although the game is for ages 3+ it did seem to work better with my 4 year old students.


It lent itself to both expressive and receptive language practice. My assistant and I modeled using whole sentences when the children drew a card from the pool "I got spaghetti." "I picked a chicken." I also asked the children questions about the food items, "Do you like meatballs with your spaghetti?" And when it was my turn to choose a card, I gave the students clues about my card before showing them, "I picked something that is a vegetable, it is long and green, and the porcupine ate it on Monday. What did I choose." We also talked about whose turn it was - "My turn." and "Your turn." When we got down the end of the game, where players only needed one or two items, we talked about the concepts of 'sharing' and 'giving' game pieces that players didn't need.

Next week at school, we'll be wrapping up Thanksgiving as we head into a 5 day break... then onto Winter and Holiday themes!


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DIY Interactive Books...

Here's a little project that I've been working on lately: DIY interactive books out of cheap discount store sticker books. I love sticker books, but the problem with sticker books is that they can only be 'restuck' so many times with a classroom full of preschool students; they about destroyed one of these 're-usable' sticker books in one a day! They did, however, have a great time with the book before annihilating it.  I set out to solve this problem with a few cheap books in hand, some cardstock, sharp scissors and my school's industrial size laminator.

Here's a farm themed sticker book that I purchased a while ago at the dollar store:


First, I took out the sticker pages and placed the stickers on a piece of white cardstock. I left a little room around them and cut them out with a little edge beyond the stickers' edge.

Then I did a little surgery and took the book apart - this one just had a couple of staples in the middle that I needed to pull out.

With all my pieces in hand, I went to the laminator and carefully sent all the pieces through - be sure to leave enough space around them to have a bit of laminating all around so that the stickers are sealed inside.


Then I cut out all the pieces again - this was the time consuming part (cutting twice), but I do think that having each piece securely encased in laminate will pay off in the long run, as the edges shouldn't peel part easily with use.

With all my pieces and pages cut out a second time, I placed soft Velcro strips inside the book (where the stickers should have been placed) and the rough Velcro on the backs of my 'sticker' pieces.


Once all the Velcro was attached, I punched a few holes in with a paper punch in the spine and used metal rings to keep the pages together. Now I have a great little interactive book that my kids love to read!


My kids practically beg to read it and love putting the 'sticker 'pieces in the book kind of like a puzzle.



We've been practicing listening skills (receptive language) in lots of different ways --
1. Listen to the animal that I describe by name, color, size, shape and/or sound then choose correct animal. 
2. Listen to a list of 2-4 animals that I name and/or describe then choose animals in correct order.
3. Listen to clues about an animal then correctly guess which animal I'm talking about.
4. Listen to directions concerning 'where' to place the animal - practicing prepositions. 

And for expressive language:
1. Students use word, phrase or sentence to tell which animal they want to put on
2. Students give oral direction to a peer about which animal to take
3.  Students describe the animal they picked by name, sound, color, shape etc
4. Students tell where they will put their animal - practicing prepositions.

This project lends itself well to easy differentiation for student strengths and needs in the context of a single group activity - simply change your questions to meet the needs of each student during their turn. It's been a great exercise in waiting for a turn and listening to their peers. There are so many ways to use little books like these - the possibilities really are endless!

I have a few more sticker books that I'm working on converting - so stay tuned for more books like these!


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